The cost of medicine: should the NHS put price labels on medicine?

Freshwater’s team of healthcare specialists examines media coverage of the Department of Health’s plans to cut NHS waste.

Health secretary Jeremy Hunt was criticised last month for ‘headline-grabbing’ after proposing in a speech that prescriptions which cost more than £20 should be labelled with their price and the phrase: ‘Funded by the UK taxpayer’.

The announcement is part of a wider plan by the government to clamp down on waste in the NHS and to foster greater individual responsibility amongst patients. The theory behind it is that by reminding patients of how much their prescription drugs cost, they will be more responsible with their medication.

Mr Hunt had cited the figure of £300 million in yearly costs to the NHS for medicine waste. This cost is the result of medicine being prescribed to people who do not use it and people who start their prescription but fail to finish the course.

Another area of focus for the government, which says it is committed to eliminating public sector waste, is missed GP and hospital appointments, which costs the NHS around £900 million a year. One policy under discussion is to fine people who miss appointments, and the Department of Health is already working on a plan to inform patients who do not attend appointments how much money they wasted.

Jeremy Hunt said: “There is no such thing as a free health service: everything we are proud of in the NHS is funded by taxpayers, and every penny we waste costs patients more through higher taxes or reduced services.”

But the plan to label medicine with price labels has been controversial. Aside for the criticisms of headline-grabbing, some have said that it will have no effect on waste and may even deter some patients from taking necessary medication so as not to be a drain on the taxpayer.

Pharmacy Voice, which represents pharmacists in the UK, said: “Although this may seem superficially attractive, there is little evidence that it will have the desired effect, and there may be unintended negative consequences.”

Whether the policy will have any effect is open to question. As Paul Gimson, former director of the Royal Pharmaceutical Society, said: “People know the price of food yet millions of tonnes of it are wasted each year. Why should medicines be any different?”

A more personal approach in which doctors and nurses spend more time discussing issues around medicine with patients might be needed. It is often the case that people stop taking medicines too early, because they believe it has worked as soon as symptoms lift or they experience unpleasant side-effects. Instead of attaching a label warning of costs to the UK taxpayer, it could be more sensible to communicate better advice about prescription medication.

Neal Patel, head of corporate communications at the Royal Pharmaceutical Society, said: “Although knowledge of the cost of medicines may play a part, it’s equally important we focus on factors such as people’s understanding of the side effects of and benefits from medicines, which will also influence whether a condition is treated effectively or the medicine ends up in the bin.”

Personal responsibility also has an important part to play in public health. People’s individual choices can adversely affect health and drain public finances; for example, consuming more calories than you burn through physical activity can cause obesity, whilst not completing a course of antibiotic medication for an infection increases the risk of the infection returning. But behavioural changes may take more than just a poster or a label. If the reasons behind the problem of wasted drugs are more to do with lack of awareness than wilful wastefulness, then discussions between individuals and direct, targeted communication with patients might be needed in order to achieve the changes in behaviour which Jeremy Hunt is striving for.

Freshwater’s healthcare team has experienceof working with NHS trusts offering services from stakeholder communications to crisis management, events and training.